Abstract
Background
The US immigrant population has grown considerably in the last three decades, from 9.6 million in 1970 to 32.5 million in 2002. However, this unprecedented population rise has not been accompanied by increased immigrant health monitoring. In this study, we examined the extent to which US- and foreign-born blacks, whites, Asians, and Hispanics differ in their health, life expectancy, and mortality patterns across the life course.
Methods
We used National Vital Statistics System (1986-2000) and National Health Interview Survey (1992–1995) data to examine nativity differentials in health outcomes. Logistic regression and age-adjusted death rates were used to examine differentials.
Results
Male and female immigrants had, respectively, 3.4 and 2.5 years longer life expectancy than the US-born. Compared to their US-born counterparts, black immigrant men and women had, respectively, 9.4 and 7.8 years longer life expectancy, but Chinese, Japanese, and Filipino immigrants had lower life expectancy. Most immigrant groups had lower risks of infant mortality and low birthweight than the US-born. Consistent with the acculturation hypothesis, immigrants’ risks of disability and chronic disease morbidity increased with increasing length of residence. Cancer and other chronic disease mortality patterns for immigrants and natives varied considerably, with Asian Immigrants experiencing substantially higher stomach, liver and cervical cancer mortality than the US-born. Immigrants, however, had significantly lower mortality from lung, colorectal, breast, prostate and esophageal cancer, cardiovascular disease, cirrhosis, diabetes, respiratory diseases, HIV/AIDS, and suicide.
Interpretation
Migration selectivity, social support, socio-economic, and behavioural characteristics may account for health differentials between immigrants and the US-born.
Résumé
Contexte
La population immigrante des États-Unis a enregistré une croissance sans précédent au cours des trois dernières décennies, passant de 9,6 millions de personnes en 1970 à 32,5 millions en 2002. Cette hausse ne s’est toutefois pas accompagnée d’une surveillance accrue de la santé des immigrants. La présente étude examine la mesure dans laquelle les tendances en matière de santé, d’espérance de vie et de mortalité diffèrent, au cours de la vie, chez les Noirs, les Blancs, les Asiatiques et les Hispaniques nés aux États-Unis et à l’étranger.
Méthode
Grâce aux données du National Vital Statistics System (1986-2000) et de la National Health Interview Survey (1992–1995), nous avons examiné les différences dans les résultats sanitaires selon le lieu de naissance. Ces différences ont ensuite été analysées par régression logistique et à la lumière des taux de mortalité rajustés selon l’âge. Résultats: L’espérance de vie des immigrants, hommes et femmes, était plus longue de 3,4 et de 2,5 ans, respectivement, que celle de la population née aux États-Unis. Comparés à leurs homologues nés aux États-Unis, les immigrants noirs, hommes et femmes, avaient une espérance de vie plus longue de 9,4 et de 7,8 ans, respectivement, mais l’espérance de vie des immigrants chinois, japonais et philippins était plus courte. Dans la plupart des groupes d’immigrants, les risques de mortalité infantile et d’insuffisance de poids à la naissance étaient plus faibles que dans la population née aux États-Unis. Conformément à l’hypothèse de l’acculturation, les risques d’incapacité et de maladies chroniques chez les immigrants augmentaient avec la durée de leur établissement aux États-Unis. Les tendances de mortalité liée au cancer et à d’autres maladies chroniques chez les immigrants et les Américains de naissance variaient considérablement; par exemple, les taux de mortalité liés aux cancers de l’estomac, du foie et du col utérin étaient considérablement plus élevés chez les immigrants asiatiques que dans la population née aux États- Unis. Toutefois, chez les immigrants, les taux de mortalité liés aux cancers du poumon, du côlon et du rectum, du sein, de la prostate et de l’oesophage, aux maladies cardiovasculaires, à la cirrhose, au diabète, aux maladies respiratoires, au VIH/sida et au suicide étaient beaucoup plus faibles. Interprétation: La sélection des immigrants, le soutien social et les caractéristiques socioéconomiques et comportementales pourraient expliquer les différences de santé entre les immigrants et la population née aux États-Unis.
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